Archive for the ‘Pregnancy’ Category

January 18th, 2018

A rush of water and blood, spilling onto the floor, soaking my socks. Did he really break my waters while I was leaning over the side of the bed? That’s how I remember it. The blood, the water, and absolutely overwhelming intensity.

Another person remarked that my OB slept in his office (or something like that) when he had a woman in labor – so he should be able to get here soon. Even so, they were convinced that delivery was imminent.

And it was.

I don’t know how long I pushed, but it wasn’t terribly long.

I pooped. I know because I did not at all like the dry washcloth they used to wipe it away.

Baby was crowning and someone encouraged me to feel the head. I reached down and found that it was not at all what I expected – it felt like the rough edge of an almond. In the rare moments between contractions, I contemplated that what I had felt must have been the edge of her head’s plates.

A giant push. Her head was out.

And then she was out.

A girl. Beth-Ellen Irene, I announced.

Someone helped me into bed so I could place Beth-Ellen on my chest. They covered us with a blanket – necessary since I’d shed all my clothing somewhere along the line. All my clothing except those now-bloody socks. Someone took them off now, asked if I wanted to keep them or just toss them. My brain wasn’t working just then, so I delayed the decision. Keep them. (Once we were home from the hospital, I threw them away, still sealed in the biohazard bag they’d been placed in.)

Beth-Ellen lay between my breasts. I was just so delighted to have her. To have her vaginally. To have her naturally. To have defied the odds.

I was also exhausted and unprepared for the “clean up.”

People talk of how the hormones flood a woman’s system, making her barely notice the third stage. And maybe they’re right. I have no memory of expelling the placenta. I barely took note when Doctor Jensen said the cord was no longer needed (In retrospect, why? Was it because it had stopped pulsating? Was it because the placenta had been delivered by then?) Someone asked Daniel if he wanted to cut the cord. He’d always been ambivalent when we’d discussed it, so I was a little surprised when he assented and did it.

But even if hormones blunted my experience of the third stage, they did little to save me from what was to come.

Beth-Ellen on my chest meant I needed to stay on the bed, couldn’t jump out of it at the extreme discomfort that was a manual inspection of my uterine scars. It was necessary to check that I hadn’t ruptured. It’s better to find out about that sort of thing sooner rather than later. But boy, that was not fun.

And then came the stitches. I had lidocaine for them, but that doesn’t mean it was pleasant. I only had superficial tears, but there were several, so the stitching took a long time.

I handed Beth-Ellen over to be bathed and weighed. I put on a clean hospital gown. The nurse returned Beth-Ellen to me and we went to our postpartum room together.

January 17th, 2018

How long did we labor like that? I don’t know. I lived from contraction to contraction. Mary offered sips of water in between, reminded me to switch positions every half hour or so.

Whatever position we tried, I ended up the same. On all fours on the bed, facing the foot of the bed. On my knees on the bed with my upper body draped over the elevated head of the bed. Standing or kneeling on the floor with my upper body over the side of the bed. Always with my legs and back at right angles to one another. Always with Daniel providing counterpressure. Liv tried the double hip squeeze at some point in there and found it effective, so Daniel switched to that.

On and on. Contraction after contraction. I started to feel desperate, but all I could articulate beyond my moos was “Oh, God, help me.” Mary picked up where I left off, praying a prayer I don’t remember now but that was exactly the trust-filled prayer I wanted to say if I could have spoken.

It must have been about then that someone wondered if I wouldn’t like to be checked. I acquiesced. I’d been wondering, but was afraid to ask lest I discover I wasn’t progressing and end up deeply discouraged. But now that someone else had suggested it, I gave myself permission to want to know.

9 centimeters. 90% effaced. With a bulging bag of waters.

Relief. I had been making progress. I would be able to deliver this baby. I started dreaming of “laboring down”, of the plateau some women experience when they’re fully dilated and before they feel like pushing. Some describe it as restful after the work of transition.

But even as my mind was dreaming of a break, my labor companions were urging action.

Could I squat during some contractions? Even push if I had any desire whatsoever to do so? Once the waters broke, surely the process would go quickly.

I squatted through one excruciating contraction and wouldn’t do it again.

They started talking artificial rupture of membranes. “I know you didn’t want this,” Mary said, “but I think you should consider it. I’m worried that you might wear out with these contractions. AROM could speed things along.”

Our team left the room so Daniel and I could talk about it. We did so in the bathroom, where I tried to pee. But I thought maybe I was starting to feel pushy and it terrified me. I pulled the call light and the staff rushed back in.

I resisted the mild urge to push (likely to the chagrin of my birth team!) Liv and the resident asked if I had come to a conclusion about AROM. We hadn’t, but I was worried about starting a timer, about ending up with another operative delivery. The resident felt that I was far enough along and the “timer” long enough that my risk wouldn’t be increased. He described the risks and benefits of delivering en caul, with the amniotic sac still intact.

We consented to AROM.

Careful to follow my birth plan, which had detailed that I did NOT give blanket consent for any procedure and that I expected to give individual assent for any and all procedures, Liv asked me to affirm that I was indeed consenting to AROM. The resident did the same, asking for consent and then, right before performing the rupture confirming: “So I’m going to rupture your membranes right now. Is that what you want?”

January 16th, 2018

The receptionist in the Emergency Department took one look at me, recognizing me from the previous night and called for OB admittance before she took my information.

Back behind the doors, an emergency room nurse exclaimed that she thought I was going to have this baby on the way upstairs. Another nurse told her that’s what she’d thought LAST NIGHT. I interjected: “This time it’s for real. Babies in my family are born on significant days – and I’m not waiting until the new year!”

Like the night before, I elected to walk to labor and delivery. Unlike the night before, this time we had to stop for contractions. I leaned over the rail in the elevator, Daniel providing counterpressure with his fists while I mooed my way through a contraction. The nurse held the door for the contraction to end. This time was definitely different.

The triage nurse was quick and efficient. Get the important information. Pause while I contract, this time on hands and knees on the exam table. Somehow, between contractions, she got me checked (5 cm dilated, 70% effaced), got a hep lock in, and monitored baby.

The resident arrived, read my birth plan, said he was on board with it. He clarified that I didn’t want routine pitocin after birth. Would I be okay if they hung a bag in my room in case there was an emergency, only using it if I did start to hemorrhage? I affirmed that, yes, that would be okay.

My nurse introduced herself, reminded me that she’d taken care of me when I was hospitalized with Louis. Of course, I remembered Liv – and I was thrilled that she would be my nurse. She, too, clarified about the pitocin.

The anesthesiologist came in to do his education. He informed me that since I’d already had two c-sections, I was going to end up with another one. He’d do a spinal, just like with the other sections. I was so glad when the next contraction hit and I could moo right over the sound of his voice, so confidently informing me that everything I’d worked for would be for naught.

He told me that, from here on out, I was not to eat or drink anything. My contraction over, I informed that I was going to drink what I wanted to. I muttered out the phrase I’d been practicing: “Feel free to document noncompliance.” The anesthesiologist grimaced as he admitted that, yes, my doctor let his laboring women have Gatorade. It was obvious that the anesthesiologist did not agree with this course of action.

The anesthesiologist left and Mary, Liv, and the resident all rushed to reassure me. “Pay no attention to him,” they said. “He does this to everyone. You’re going to rock this labor and have this baby normally.”

And then we labored, much like we’d been laboring at home – except with Mary holding my hands and reminding me to keep my vocalizations low and Liv unobtrusively monitoring baby with a Doppler.

We tried using the rebozo around my hips. I waved it away and gestured that I needed the counterpressure again. We tried Mary’s massage tool. Nope, that wouldn’t do. Mary tried to give Daniel a break, but she was a hundred pounds too light to provide the pressure I needed. Daniel would only get a break when I did.

It took about three contractions before Daniel asked what he should be doing. Should he be trying to sleep (as I’d been urging him all along – he needed to conserve his strength until I needed him) or was there something he should be doing for me?

This time, my answer was unequivocal. I needed his help. Desperately.

I was on all fours on the bed, rocking my hips side to side and back and forth. My back and buttocks hurt, oh so badly. I groaned, but it wasn’t groaning so much as bellowing – a deep moo that lasted so long I wondered how I could keep going with the relatively short gasps of air between each bellow.

I directed Daniel to find the tennis balls in a sock that I’d prepared for a pain relief measure. Press those into my back. No lower, lower. In those dimples, just above my bottom. More, more. Until his entire upper body weight was pressing the tennis balls into those dimples. When he was pressing there, I could at last feel a little relief.

He didn’t like the sock I’d put the tennis balls in, so he found some other socks from the closet and switched them out in between contractions – and into the next contraction while I begged him to be done and use them NOW.

I texted my doula, who asked if I wanted to go in and get checked. I replied that I was nervous about repeating the night before.

Mary suggested that I get in the bath, which is what I did.

I labored on all fours in the bathtub, with Daniel leaning over me to provide counterpressure during contractions. At first, Daniel timed the contractions on my phone, but as things continued with great intensity, I needed help between contractions too. Daniel had suggested a podcast to occupy the time between contractions (he was worried about getting bored, but quickly lost that worry!) I vetoed a podcast and suggested instead that Daniel read through the Scripture passages I’d put in my laboring notebook. Daniel read Psalm 139:1-18, various verses from Psalm 37, Psalm 34:1-10, Philippians 4:4-9, Isaiah 40:28-31, Psalm 57:7-11, Psalm 71:5-6 and 17-11. When I started mooing, he set aside the book to apply counterpressure again. He flipped back to the beginning of the book and started reading through again. Every so often, when the pressure between contractions became too intense, I opened the tub’s drain and turned on the water as hot as I could handle, backing up to direct the spout of water as close to my lower back as I could get it.

An hour passed. Contractions were 3 minutes apart, 30-60 seconds long and requiring total concentration.

I dictated a message for Daniel to send to Mary. She thought I should go in.

I dried off, sat on the toilet and checked my dilation. I’m no birth professional, but I could tell I’d made progress. This was no repeat of the night before.

January 13th, 2018

It was Christmas Eve, and given that we’d labored 24 hours for two centimeters progress, I couldn’t put everything on hold just because I was in labor.

Then again, the contractions were continuing and were requiring my total focus. They were still a minute long and five minutes apart, but I couldn’t talk through them anymore. That was enough to rule out the morning worship service.

We settled on preparing my family’s traditional Christmas Eve meal. Daniel transferred one soup from the container I’d frozen it in to the crockpot (because Daniel has tried oyster soup when we were engaged and had found it wanting). I prepared the oyster soup. I pulled out the platters and the dishes and directed Daniel and his mom as they set the table and arranged the veggies and dip, the crackers and cheese and summer sausage and cheese ball, and the relish tray with pickles and olives.

Somewhere over the course of the morning, Tirzah Mae noticed her mother’s lack of responsiveness to her (during contractions). In between contractions, I explained: “Remember how mama said the baby would let mama know when it was time to be born? The baby would talk to mama by making her belly go” and then I squeezed my belly on either side, making it bulge further in front. “Well the baby has started talking to mama to tell her that it’s about time for the baby to be born.”

We sat down for our Christmas meal – Grandma and papa and the children in chairs, mama on her birthing ball. Every few minutes, I stood up, leaned over the wing back chair behind me (in the living room), rocked my hips and groaned a bit as the next contraction hit. Then I’d sit back down and eat a bit more.

If we were in a race to finish Christmas dinner, I’d have been dead last. Tirzah Mae would have been the winner. And, as is often the case when Tirzah Mae finishes her meal before me, she wanted to snuggle. But there was no way she was getting on that ball with me. It was hard enough trying to eat and manage contractions and balance on the ball and try to be pleasant at the table. I acquiesced to having her scoot her chair close to me so she could rest her head on my belly (when I wasn’t contracting, of course.)

She laid her head on my lap, patted my belly and said in the sweetest little voice: “Stop talking to mama, baby. It makes her crabby.”

The baby didn’t listen to Tirzah Mae’s advice (thank goodness!) Contractions continued, varying from five to fifteen minutes apart, but continuing to increase in intensity. Unable to concentrate on anything too focused (i.e. a book), I downloaded a Sudoku app on my phone and began methodically working through its puzzles between contractions. As the day wore on, the contractions started more abruptly, ramping up to seven or eight right away instead of slowly increasing to a peak.

Nevertheless, we went to bed yet another evening, still in latent labor.

January 12th, 2018

We discussed the possibility of malpositioning as the allotted hour of walking came to a close. If baby were posterior, perhaps that could explain how I’d been laboring so long and hard with so little progress.

We knew with my history of severe preeclampsia that we didn’t want to do anything inverted, but my doula could do a side-lying release and we could see if that helped things out any.

Are you feeling lost? Maybe you’d like to read part 1, part 2 and part 3 of Beth-Ellen’s birth story

The doulas also wondered about nipple simulation, but I was unsure. I was still torn between the desire to get labor over with and the desire to have enough strength to bring it to completion.

The triage staff were busy when we returned after our hour of walking, so we began the side-lying release.

The resident came back to check me. No progress. No surprise there.

But I couldn’t leave yet. They needed to check the baby again. This time, I insisted on standing. I continued chatting with Daniel and Mary (my primary doula), pausing every three minutes to lean over the bedside table and sway my hips or lunge a bit as another contraction hit. These were at mid-day intensity now – but nothing I couldn’t manage by myself.

A twenty minute tracing stretched to thirty, forty minutes. Even longer. It must have been quite an emergency the other woman was having.

Mary mentioned that one of the nurses had recognized me, asked my name. She’d taken care of me with Louis and had requested to be my labor nurse if they kept me. My mind jumped to the two primary nurses who’d taken care of me with Louis. I felt sure it was one of them, and I felt a twinge of regret that I wouldn’t be staying. But I’d be crazy to stay when I was two centimeters dilated.

The triage nurse finally returned. She took a look at my tracing, at those every three minute contractions, and called the resident. She knew he’d been intending to send us home, but these contractions were pretty close together. Could he come back in and check me again? Or maybe she could just do the check if he was busy?

She got off the phone and I told her not to bother. These were the same contractions I’d been managing fine at home for a good part of the past twenty four hours. Contractions that had dilated me to a 2 in that time. I’d go back home and manage labor there until something changed.

Which is exactly what we did. We went home and went to bed. By this time, I was exhausted enough that I did something like sleep between contractions. I lay there in a left side-lying Sims’ position between contractions, drifting in and out of consciousness. And when the contractions came, I rose onto all fours, raising my bottom as high as I could and lowering my chest as close to the bed as I could manage. If malpositioning was our problem and I could get this baby into a better position through my own positioning, I was going to try.

I can’t have slept long, given that we didn’t get home until three or four – and the children generally wake up between six and seven.

But the rest felt delightful, and now it was Christmas Eve – when my family traditionally celebrates Christmas.

January 11th, 2018

The contraction pounded my whole being awake. The sudden intensity no doubt caused me to do exactly what I shouldn’t have done – to tense every muscle.

I was still breathing hard from the contraction that awoke me when a second slammed through.

From sleeping to drowning in three minutes or less.

Are you feeling lost? Maybe you’d like to read part 1 and part 2 of Beth-Ellen’s birth story

Daniel woke up beside me. Who could sleep through such intensity? I timed just a few contractions and sent a desperate text to my doula.

I needed her to come. I couldn’t manage these. They were at least a minute long, but some were coming as close as every two minutes. I couldn’t catch my breath in between, much less still my mind.

My doula called, heard my panting hello (I was between contractions just then), and suggested we head to the hospital.

We went through the list of last minute packing items – phones and cameras and chargers and popsicles. That is, I pointed to the list in between contractions while Daniel collected items.

I paused a dozen times on my way from our bedroom to the front door. Stopping to lean against the wall, over a chair, against the living room shelving, over the children’s play table. A voice in the back of my head reminded me to keep my vocalizations low, but all that came out was cries of agony.

My mother-in-law awoke (or did she sleep at all? The terrible waves started less than an hour after I’d tucked myself into bed.)

We finally made it out of the house and into the car, where I chafed at the seat and the belt – basically at anything. The washboard road and potholes we’d been hoping would put me into labor a week ago taunted me. Was this what you wanted?

In a brief moment between those terrible contractions, I noticed that it was almost eleven. This baby would be born on Christmas Eve, no doubt. Go figure. Babies in my family insist on being born on significant days.

Then the terrible thought intruded. What if we got there and I wasn’t progressing at all? What if I were dilated to two? I started shaking, the same sort of out-of-control shaking that had convinced me to ask for c-section with Tirzah Mae.

We arrived at the hospital, drove past the ER entrance, turned around and started through.

ER was swift and efficient. They were convinced I’d be delivering on my way upstairs to labor and delivery. Nevertheless, I refused a wheelchair, remembering the agony of sitting in the car during contractions.

It didn’t matter. I didn’t have any contractions on the way up to labor and delivery. Didn’t have any until they insisted that I sit on the examination table in triage to be checked and to check out the baby.

40% effaced, the resident announced. Dilated to 2 cm.

I could have cried, but a contraction began and I was sitting on that terrible table. I tensed my arms to lift my bottom off the table and the nurse told me if I wanted to have a natural birth (she’d had two, she told me, out of seven total) I’d have to learn to relax through the contractions.

In retrospect, her admonition was completely true – but, in the moment, all I could think was “I can relax – if I’m allowed to stand up!”

The baby’s tracing was normal. The resident suggested I stay an hour, walk the halls, see how far I’d progressed by then.

And so we did. My doulas were there now, so we walked in circles through labor and delivery. I caught them up on the events of the day, explaining to them that the contractions I was experiencing right now? About a minute long every five minutes or so? These were like the contractions I’d been having at seven this morning. Enough that I had to stop and manage them, but mild enough that I could even talk through them (so long as I could move around, of course).

If I was discouraged that afternoon, it had nothing on this evening.

I was going to be cut open again. My body couldn’t do labor. Given my mental state when I came in, maybe my mind couldn’t do labor either.

But at least I hadn’t progressed far enough that they’d suggest me staying. If there’s one thing I knew, it was that being at the hospital would erode my chances of a vaginal delivery even more.

So I walked and talked with my doulas, biding my time until the hour was up and the resident could send me home.

But sleep continued to elude me. Lying down was certainly not conserving mental strength – it did nothing at all to distract me. Every bit of my mental and physical energy was focused on trying to relax through the contractions and the continued pressure. After another hour or so, I gave up and got up, joining Daniel in the living room.

I’d try that distraction thing.

I wrapped the last of the children’s Christmas presents. I started the new year’s bullet journal layouts – indexes and future log, a calendar page for January. I read from my NIV Sola Scriptura Reader’s Bible.

Contractions were still coming every 3-5 minutes, 30-60 seconds long – but the distraction let me (mostly) ignore the pelvic pressure in between contractions.

The kids woke up and I retreated back into the bedroom, where I napped-ish for an hour and a half or so.

Grandma arrived around 9:30 am.

I returned to the living area and puttered about, doing a little laundry, a little tidying, a little this and a little that. I turned on the “worship to sing” playlist I’d prepared for laboring. Contractions continued, a minute long every 3-5 minutes. When the contractions came, I lunged in place or rocked my hips to the music.

We ate lunch together and I retreated back to the bedroom in an attempt to get a little more sleep. At this point I’d been laboring just over 12 hours – what my book says was the upper limit of a usual latent labor.

“I think I need to conserve strength if possible”, I told my doulas via text, right before I headed to bed.

An hour and a half later, I texted them again: “Huh. Well, I got a bit of sleep and it’s like things have just stopped. I still feel a bit crampy, but I haven’t been feeling any contractions.”

But within another hour, we were back to where we left off. Contractions every 3-5 minutes, had to stop to focus on them but could still talk through them. When I sat down (even bouncing on the birth ball), they slowed down and lost some intensity – and as soon as I stood up they increased in frequency and intensity. I was becoming discouraged and confused. This was still obviously (to me) not yet active labor – I was managing on my own, not needing Daniel’s help to manage contractions. But should I still be trying to conserve strength? I’d had three or four hours of sleep in the past 36 hours. Maybe I should instead stay standing, try to get things to intensify so we could just make progress?

One of my doulas reminded me of the verse she’d read earlier that week, when I’d been fretting over how long this baby was taking in coming: “The voice of the Lord makes the deer give birth” (Psalm 29:9) The Lord’s voice would bring forth my baby as well, at just the right time.

We ate dinner, put the children to bed. I had some diarrhea (a good sign, my book told me), took a bath, went to bed.

By now, I was ten hours past the book’s 12 hour upper limit for latent labor. I knew better than to place too much stock in the numbers, but it was still discouraging. I’d tried so hard to act according to the book, to conserve strength and to distract myself. But my body just wouldn’t stick to the book at all. The contractions started where they stayed, 3-5 minutes apart. They increased in length and intensity – but slowly. And the latent phase was lasting forever.

January 9th, 2018

Lucky women begin latent labor late in the day. I don’t remember when or where I read it, but I hoped to be one of those lucky women who could sleep between contractions as the time between contractions decreased from 30 minutes at the onset of latent labor to 5-6 minutes apart at the beginning of active labor.

I imagined myself trying to conserve strength if labor started during the day – and almost always imagined myself failing. I’m not good at doing nothing, especially if I know I’ve got a baby coming imminently.

So every night for the previous 3 or 4 weeks I’d been tucking myself into bed, praying that tonight would be the night – and that I’d sleep right through most of it.

By this time, though, my hope was wearing thin. This baby was showing no signs of budging. My cervix was firm and closed, as closed as it’d been at 37 weeks – 4.5 weeks ago, when we’d declared this baby free to come. In my most discouraged moments (and even in some of the less morose ones), I was sure we’d get to 43 weeks, still closed and I’d be cut open again, effectively barring me from any hope of a normal delivery ever.

So I wasn’t hopeful the evening of December 22 as I fell into bed exhausted at nine or ten.

No matter. Babies do not seem to pay much attention to their mother’s hopes – or if they do, they do so only to tease.

I awoke to strong contractions at eleven. These were clearly different than the Braxton Hicks I’d had on and off for the past many months. I could not ignore these. Nor could I rest between them. The contractions ebbed and flowed, but the incredible pressure between my sitz bones did not.

I moved to the couch lest I wake Daniel. Even if I could not conserve my strength, I’d try to conserve his. I writhed, I breathed, I tried all the distraction measures I’d been practicing to try to take my mind off the pain, the pressure. After an hour, I decided to go ahead and focus on the contractions enough to time them.

A minute long. Six minutes apart. This was not what I’d read to expect. These were supposed to be shorter, further apart. I was supposed to be able to sleep between them.

I went to the bathroom around one, now on December 23rd. The bloody mucous plug told me that something really was happening.

But I wasn’t managing this early part well. It started so much more intensely than I’d expected. And I knew from a quick check in the bathroom that it wasn’t because my cervix was opening rapidly.

I debated a bath. I needed relief from the never-ending pressure, but I didn’t want to slow down this labor that had taken so long to start in the first place. If I’d read it once, I’d read it a half dozen times. A soak in early labor will slow things down. Wait until you’re in active labor to get in a birthing pool.

The need for relief (and the desire to maintain Daniel’s strength for the active part when I was sure I’d need him) won out. I took the bath, experienced sweet relief from that awful pressure. As promised, the contractions decreased – somewhat. They were now only 15-45 seconds long, but still coming every four minutes.

I felt relaxed enough when my bath was done to get into bed and try to sleep. I texted Daniel that labor had started and that I was going to try to sleep (still trying to conserve his strength – especially because he has a hard time napping during the day).

The pressure returned. I could keep myself in a left-lying Sims’ position only by mentally singing through my trouble hymns.

I breathed my way through “Great is Thy Faithfulness”, through “How Firm a Foundation”, through “It is Well with My Soul”. I started over, the songs the only thing between me and tears. It was so intense, so early. How would I manage active labor if I was having so much trouble with the latent stuff?

I couldn’t think about that, had to stay in the moment. I sang through my trouble songs again, reminding myself of the strength outside myself, by whose strength I could endure whatever might come.

December 26th, 2017

After 55 hours of labor, we were pleased to welcome Beth-Ellen Irene Garcia into the outside world on Christmas Day.

She was born at 42 weeks, just like her mother before her, and, by the grace of God, via an unmedicated vaginal birth after 2 cesarean sections.

She is the answer to prayer, a delightful Christmas present. But, as the reporter from our local news forced me to clarify, Beth-Ellen is not the greatest Christmas present ever.

As I told the reporter (unfortunately, the most important part got left out of the news clip), that distinction is reserved for another baby, one born over 2000 years ago. Because while Beth-Ellen came on Christmas to be a part of our family, Jesus came as “not just a member of our family but someone who came to make us a member of God’s family, and that’s truly the greatest gift. And what a treasure we have to be able to share that with our daughter, our Beth-Ellen.”

Rejoicing in the Incarnation – and in this precious gift we get to share Christ’s gift with.